Inside the human mouth, teeth are disposed in dental alveoli, commonly referred to as tooth sockets. Dental alveoli and teeth are included on both the maxilla (upper jaw) and mandible (lower jaw). Typically, twenty (20) primary or “baby” teeth are initially grown that eventually fall out and are replaced by twenty-eight (28) permanent or “adult” teeth. Some individuals experience the growth of up to four (4) third molars or “wisdom teeth” as well.
Various problems can manifest in teeth and tooth sockets. For instance, bacteria can be a frequent cause of tooth decay. Sometimes, the extent of such decay precipitates the extraction or removal of said tooth by a dentist, oral surgeon, or other medical practitioner. Tooth extraction can be achieved, for example, by grasping the tooth with forceps and performing a rocking motion to loosen the tooth from the alveolar bone. The tooth is loosened from the alveolar bone when connecting ligaments, or periodontal ligaments, that secure the tooth in place are gradually broken. Eventually, the tooth may be removed from the socket, thus exposing the dental alveolus.
Tooth extraction may also be required when, for instance, certain teeth are causing overcrowding in the mouth, malocclusion, or preventing the eruption of other teeth from the gum line. Wisdom teeth extraction has increased in popularity over the years. Further, tooth extraction frequently occurs prior to and in preparation for orthodontic treatment such as braces or dentures. Additionally, tooth extraction may also be precipitated by gum disease and/or cancer.
Trauma to the oral cavity and contained tissue and structures can also effectuate or require the removal of teeth. Occasionally, self induced trauma is caused by attempts at extracting primary teeth. More frequently, car accidents, sporting events, and the like cause trauma to the oral cavity and result in undesired tooth extraction.
Pain and bleeding are common during and after tooth extraction procedures and events. Pain is frequently caused by alveolitis, or swelling of the tooth socket, whereas bleeding results from the manipulation and/or destruction of proximate tissue. Alveolar osteitis, or dry sockets, can also materialize in the exposed tooth socket following tooth extraction when a blood clot forms, thereby depriving the tooth socket of blood. While the cause of this complication is substantially unknown, the associated pain is readily appreciated by anyone who has experienced dry sockets. In this regard, prevention is generally promoted by encouragement to keep the exposed socket clean and moist. Further, treatment is typically effectuated by applying medicated paste containing, for example, eugenol, benzocaine, and/or iodophorm. Hydrogel dressings, which release water to maintain a moist wound environment, have also been used in this context.
Methods of promoting healing, alleviating pain and swelling, and ameliorating bleeding are known in the art. Gauze pads, tulle, cottons swabs, or the like can be introduced into the oral cavity and compressed against the exposed alveolus to promote hemostasis and absorb blood and other leaked fluid. Pressure is particularly important for achieving hemostasis, however bioactive ingredients such as chitosan can serve as an effective supplement. For instance, U.S. Pat. No. 7,897,832 discloses dental dressing assemblies that are formed from hydrophilic polymer sponge structures, such as densified chitosan biomaterial.
Another known supplement that can be combined with pressure to assist in achieving hemostasis is tannin. Tannins are present in many woods, where they provide a partial defense against wildfires, decomposition, and infestation. Tannin is also a frequent ingredient in tea and is typically sold commercially as tannic acid. Tannin is known to constrict blood vessels in tissue and is a topical substance. Therefore, doctors frequently suggest biting down on a tea bag containing tannin following tooth extraction to help stop bleeding. Research also suggests that tannin has antiviral, antimicrobial, and antibacterial properties.
Hemostasis is also achieved, in part, by coagulation, or clotting, of the blood. Briefly, coagulation occurs when damaged blood vessels are covered by platelets and fibrin. Fifteen primary factors are required for blood to coagulate. Among those factors are fibrinogen and calcium. Both the intrinsic and extrinsic pathways associated with coagulation require ample amounts of calcium to initiate and progress the cascade of chemical reactions that cause coagulation. Chitosan is also known to help promote coagulation.
Pain and swelling associated with tooth extraction are often combated by applying cold therapy to the oral cavity. Typically, this is achieved by placing an ice pack or like device on the exterior of one's cheek, proximate the exposed tooth socket. Most individuals experience some pain relief when their wound site is exposed to cold therapy. Cold therapy is an effective pain remedy because cold temperature, when applied to nerve cells, lowers the resting membrane potential of the individual neurons. FIGS. 15A & 15B illustrate example sin curves of neurons responding to a stimulus. Neurons transmit electrical signals in response to stimuli by increasing the voltage within the membrane of a neuron to surpass a certain threshold level, also referred to as action potential. FIG. 15A illustrates an example voltage increase of a normal membrane having a resting potential of −70 millivolts. In order to achieve action potential for the electrical signal to be transmitted to the next neuron, the voltage increase from the resting membrane potential of −70 millivolts must surpass a certain threshold level of millivolts, in this instance −55 millivolts. Thus, when the resting membrane potential is lowered, for instance by cold therapy, as illustrated in FIG. 15B, a higher voltage increase will be necessary to achieve the threshold level required for transmission of the electrical signal. Therefore, lowering the resting membrane potential enough so as to preclude the voltage increase from surpassing the threshold level will prevent the sensation of pain to be transmitted between neurons.
Likewise, swelling often subsides when cold therapy is applied to the swollen tissue. Swelling is frequently caused by an excess amount of blood and fluid leaking from ruptured capillaries. Cold temperature causes the blood vessels within the swollen tissue to constrict or narrow. Also called vasoconstriction, this occurs when the smooth muscle within the blood vessels contract and clamp down, thereby minimizing and/or preventing further leakage of blood and serum. By this same principle, vasoconstriction also plays a critical role in achieving hemostasis.
Ice packs, however, frequently go too far in terms of applying cold therapy to the exterior of a cheek. Ice and other frozen things can create cold burns on the skin. Even more dangerous is when ice causes the skin to become numb, thus preventing the individual from noticing the tissue damage taking place. Further, cold therapy applied on the exterior of the cheek is not an efficient application of such therapy to an exposed tooth socket. Having to travel from the exterior of the cheek, through the skin and tissue, and then into an exposed tooth socket prevents the efficient application of cold therapy to the tooth socket. Additionally, the regional application of cold therapy minimizes the pain relief desired for the specific wound site. Stated differently, the lack of focused cold therapy applied locally to the tooth socket sacrifices the therapeutic effectiveness of the ice pack.
Thus, what is desired is a dental dressing capable of applying localized cold therapy to an exposed tooth socket without using ice or other frozen things. More particularly, what is needed is a dental dressing containing a pre-shaped therapeutic member that can fit in an exposed tooth socket, substantially between contiguous teeth, and apply localized cold therapy to the exposed socket while also helping prevent post-operative complications. Further desired is a dental dressing capable of containing moisture and topical agents that, when applied to an exposed tooth socket, promote healing and/or reduce pain.